Dr. Birbeck is a neuroepidemiologist interested in studying epilepsy in sub-Saharan Africa. Her tong-term goals include investigating common neurologic conditions that have often been understudied in developing countries. Although risk factors for epilepsy have been extensively studied in the US and UK, these findings cannot be extrapolated to regions where lifestyle, infectious exposures, and other environmental and social conditions differ drastically. In this K23 application, she proposes a neuroepidemiologic study in Malawian children admitted to the Blantyre Malaria Project (BMP-MLW) to determine whether cerebral malaria is a risk factor for epilepsy. She will conduct a descriptive study incorporating electroencephalography (EEG) into the existing BMP-MLW enrollment data to assess clinical and autopsy correlations with serial EEGs obtained during acute cerebral malaria infections. A prospective exposure-control study of children with cerebral malaria discharged from the BMP-MLW research ward and a control population of age-matched children discharged from the general pediatrics ward (without a history of cerebral malaria) will then be followed prospectively to determine the relative risk of epilepsy after cerebral malaria. Among cerebral malaria survivors identified in the prospective study, a multivariate logistic model will be developed to assess the clinical features of acute cerebral malaria that are associated with epilepsy development. To be better equipped to evaluate epilepsy in sub-Saharan Africa, Dr. Birbeck proposes to acquire a Tropical Medicine diploma and to seek further training and certification as an electroencephalographer. EEG is not only valuable in the assessment of epilepsy but offers a relatively inexpensive measure of brain function that can be obtained in settings with minimal existing medical infrastructure. To acquire these additional skills in EEG interpretation and Tropical Medicine and to conduct the proposed study, Dr. Birbeck's work will involve three institutions: Queen Elizabeth Central Hospital in Blantyre Malawi, the Henry Ford Health System, and the Liverpool School of Tropical Medicine and Hygiene. During this K23 Award, she will maintain her position as an Assistant Professor at Michigan State University where the African Studies Center and Institute of International Health foster several collaborative, international projects and where her mentor, Dr. Terrie Taylor resides.